Prostate Cancer Treated With External Beam Radiotherapy

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Dear OncoLink "Ask the Experts,"
I am requesting information on prostate cancer. I had surgery in March of 1993. The doctor was unable to get to the gland to remove it. He took out the lymph nodes and they were negative. I had 39 radiation treatments. My follow-up results were good.

I then progressed from 3 month exam intervals to 6 months, and am now at 1 year intervals. Please tell me if this seems like a normal course of treatment.
Thank You
JB

Neha Vapiwala, MD Senior Editor of OncoLink and Assistant Professor in the Department of Radiation Oncology at the Hospital of the University of Pennsylvania responds:

Dear OncoLink Reader:
Thank you for your question.

The recommended follow-up regimen for prostate cancer patients who were treated with external beam radiotherapy is similar to what you describe. Typically, you are evaluated by your physician every three months for the first year or two, then every four to six months for another year or two, and then yearly from then on, assuming there are no concerning findings at any of the regular visits. During these follow-ups, your radiation oncologist will perform a complete physical examination, including a digital rectal exam on which the prostate can be palpated for any new nodules or growths. In addition, a serum PSA (prostate specific antigen) level will be measured around the time of each visit. The PSA blood test and physical exam will detect the large majority of recurrences. At this time, there is no proven beneficial role for regular CT scans, MRIs, or PET scans in the routine follow-up of treated prostate cancer patients. If there is a specific complaint or a suspicious finding on digital rectal exam, a CT scan or MRI of the pelvis may be ordered to help evaluate further.

Mar 3, 2015 - Men with prostate cancer who receive salvage external beam radiotherapy after radical prostatectomy have a low risk of severe late toxicity, according to a study published online Sept. 22 in Radiotherapy & Oncology.